GHC Musculoskeletal (MSK) Physiotherapists Tomas Bullock and Cerys Watcyns are based in the Forest of Dean and are running popular ESCAPE-pain exercise sessions in Lydney and Cinderford.
ESCAPE-pain stands for ‘Enabling Self-management and Coping with Arthritic Pain using Exercise’ and is an evidence-based, cost effective, group rehabilitation programme for people with chronic joint pain. It integrates educational self-management and coping strategies with an exercise regimen individualised for each participant as Tom explains:
“The programme was originally developed by Professor Mike Hurley for people with knee osteoarthritis. It is designed to help patients cope with hip and knee osteoarthritis where myself and Cerys are facilitators.
“GHC has been very supportive and provided funding to help us become trainers and facilitate the course. Currently, I am the only ESCAPE-pain facilitate for back pain in the county but I am aware more are being trained, whereas the hips and knees have been going on for 3-4 years and it in multiple locations across NHS England. Patients who have come through the course previously have found it very beneficial. The aim is to empower patients to control and manage their pain rather than the pain controlling or managing them. This is achieved through education and getting the patients to appreciate the effectiveness of simple exercise which is devised through an exercise circuit.
“The course comprises ten sessions over 5 weeks for an hour each session. By the end of the course we hope that participants will feel confident to manage their symptoms long-term, which means for the patient better quality of life and less time off work. For our service this could also mean less waiting times and stress for other patients”.
Tom offers the Back ESCAPE-pain course at the Freedom Leisure Centre in Lydney, as he explains:
“Back pain comprises most of the patients that we see as physios, we wanted to help patients to manage this more independently.”
Cerys offers the Hip and Knee ESCAPE-pain course mainly at the Freedom Leisure Centre in Cinderford and both Tom and Cerys alternate offering this course in Lydney. Cerys said:
“It’s quite nice for them to be in a group environment. I think that’s attractive to a lot of the people we see as they wouldn’t ordinarily go to a gym on their own, but after these sessions, some of them will continue doing this on their own – sometimes with other people they have met on the course which is quite nice.”
Most participants are over the age of forty and most sessions are patient-led. Both Tom and Cerys have noticed that the sessions really help with confidence, as Tom explains:
“People don’t realise what they can achieve – whether it is back arthritic pain or hip and knee arthritic pain, some people can feel quite isolated and showing them what they are capable of makes a huge difference and no matter what age, they’re in the gym, they’re using equipment and that makes them feel much better about themselves.”
Cerys adds: “I had a lady in one of my groups who said she’d never come to the gym, she struggled to get on the spin bike in the first session and she didn’t really want to come back, but she came back and we worked through it and, by the end of it she was so grateful and she thanked me for giving her that confidence to try different things and she planned to carry on afterwards. It’s a short space of time to see huge differences in terms of strength and pain and a big part of it is the education to help them manage it themselves”.
“Before coming to us, they would have seen a physio wither in a hospital outpatients department and have a few goals in mind and the classes are generic in terms of structure, but then if there is something specific they want to achieve, for example I had someone who couldn’t do the stairs, so we work on step ups. Getting up off the floor is quite a common thing actually and it is surprising the amount of people who do struggle with functional tasks like that. So as the weeks go on, you get to know the individuals and what they want to take out of it and you can tailor it a little bit”.
Sue Hillier (pictured) is a former District Nurse and was referred by her GP to the Gloucestershire Health and Care NHS Foundation Trust Physiotherapy team:
“I have noticed a big difference; as someone who doesn’t like exercise, this is something I will take forward. Am now thinking of joining the arthritis class run by the Leisure Centre*.”
*Freedom Leisure Centre in Lydney offers a follow-up class to enable patients to continue with their exercise regime after the group has finished.
For Tom, the best bit about the course is seeing the outcome at the end: “Seeing where they came to us at the start and seeing how much, even in a short period of time, how much it’s helped them from a confidence point of view, what they can do now that they didn’t used to do before; it’s just the positivity from it. People say that when you get older, it’s just going to get worse, but when you see what people are doing here in the gym, it’s nice to see that age is just a number at the end of the day.”
To be able to be referred to the class, you will need to be reviewed by an MSK Physiotherapist or a MSKAP clinician to ensure you meet the criteria for the class. Patients are able to self-refer into physiotherapy online or by contacting the admin team, or through your GP.
